Individual
JOHN THOMAS BOLGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 DELAFIELD ST, SUITE 120, WAUKESHA, WI 53188-3417
(262) 544-5311
(262) 544-6820
Mailing address
1111 DELAFIELD ST, SUITE 120, WAUKESHA, WI 53188-3417
(262) 544-5311
(262) 544-6820
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
22872
WI
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
22872
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30417700
—
WI
Enumeration date
11/11/2005
Last updated
10/23/2007
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